Flight Medic Class Flashcards
(138 cards)
1
Q
Succinylcholine
Adult Dose
A
- 5 mg/kg IV
- 5-4 mg/kg IM
150 mg MAX
2
Q
Succinylcholine
(Pedi)
A
1 - 1.5 mg/kg IV
2.5 mg/kg IM
50 mg MAX
3
Q
Succinylcholine
(Contraindications)
A
Hypersensitivity
Penetrating injuries to the eye
History of glaucoma/Ocular pressure
Malignant hypothermia
4
Q
Rocuronium
Adult Dose
A
1 mg/kg IV
5
Q
Rocuronium
Pedi Dose
A
1mg/kg IV
6
Q
Rocuronium
Contraindications
A
NONE
7
Q
Vecuronium
(Adult Dose)
A
0.1 mg/kg IV
8
Q
Vecuronium
(Pedi Dose)
A
0.1 mg/kg IV
9
Q
Vecuronium
Contraindications
A
NONE
10
Q
Hypoxic Hypoxia
A
“”Ain’t enough Air getting to the lungs””
Airway obstruction
ARDS
Decrease partial pressure of oxygen at high altitude
Tension Pneumothorax
{Patient will turn Blue}
11
Q
Hypemic Hypoxia
A
“Not enough Blood” 🩸
Lack of blood volume (Hypovolemic Shock)
Anemia or hemorrhage
TXA is used during Hypemic Hypoxia
12
Q
Stagnant hypoxia
A
“Blood Ain’t Moving”
Cardiogenic shock Distributive shock Septic shock Anaphylactic shock Neurogenic shock Obstructive shock
{Patient will turn Blue}
13
Q
Hysto-toxic Hypoxia
A
Cyanide Poison
Carbon monoxide
Alcohol poisoning
14
Q
Which side of the O2 disassociation curve is Acidosis?
A
The right side
15
Q
Which side of the O2 disassociation curve is alkalosis?
A
The left side
16
Q
What is bad about the right side of the O2 disassociation curve?
A
It can’t carry O2
17
Q
What are symptoms for the right side of the O2 disassociation curve?
A
High Heart rate High metabolic state High fever Low respiratory High 23DGP
18
Q
What are symptoms of a left-sided disassociation curve?
A
(Left side = Alkalosis)
Low temperatures
High respiratory
Low 23DPG
19
Q
How do you reverse a high 23DGP?
A
Calcium gluconate
Calcium chloride
20
Q
Explain base excess?
A
The more negative you are, the more acid you have
It’s a great way to trend any shock status
21
Q
Explain the Gap?
A
Greater than 12 is acidosis
Less than 12 your normal
22
Q
Sodium bicarb is the poor man’s what?
A
Dialysis machine (helps urinate/expel acid)
If it’s potassium related, get calcium first
23
Q
What’s the formula to reach a desired ETCO2?
A
(Respiratory Rate X ETCO2)
—————————————
Desired ETCO2
= New Respiratory Rate
24
Q
If you have a respiratory alkalosis, what should you ALWAYS rule out?
A
Metabolic acidosis (possible underlying cause)
25
What are the Golden Rules of ABG's?
1. Every 10mm/Hg change in CO2, the pH will change 0.08 in the opposite direction
2. For every change in Bicarb of 10 mEq, the pH will change 0.15 in the same direction
3. Formula for calculating Bicarb replacement Kg/4 X base deficit = Bicarb needed
26
Name the Gas Laws?
```
Boyle's Law
Charles' Law
Dalton's Law
Henry's Law
Gay-Lussac's Law
```
27
Describe Boyle's Law?
o Effects equipment and anything that contains air
| o Higher the altitude the more gases expand
28
Describe Charles' Law?
o Air expands when hot. Aircrafts love cold and dry air
29
Describe Dalton's Law?
o As altitude increases, partial pressure decreases, Supplemental O2 is needed (Hypoxic Hypoxia)
30
Describe Gay-Lussac's Law?
o If Temperatures increase, O2 tank pressure increases
31
Describe Henry's Law?
Diving adds pressure, when surfacing nitrogen comes out
32
Adenosine dose for Heart Transplants / Central Lines?
1st Dose: 3mg
| 2nd Dose: 3mg
33
How many MM of pressure can the brain take before it herniates?
15mm
34
How to calculate the B/P?
CO x SVR = B/P
35
How to calculate Cardiac Output?
HR x SV = CO
36
High SVR equals?
Vasoconstriction
37
Low SVR equals?
Vasodilation
38
What happens during narrowing pulse pressure?
Vasoconstricting
39
What happens during widening pulse pressure?
Vasodilation
40
What are the STRESSORS of Flight?
```
SELF IMPOSED
o Dehydration
o Exhaustion
o Alcohol
o Tobacco
o Hypoglycemia
INHERENT
o Thermal Changes
o Humidity
o Gravitational Forces
o Fatigue
o Partial Pressure of O2
o Barometric Pressure Change
o Noise
o Vibration
```
41
When ascending to altitude, if your FIO2 IS 40%. What should your PEEP be?
PEEP of 5
42
What is a Steril Cockpit?
Only essential communication during all phases of flight except straight and level flight
43
What are Critical phases of flight?
o Takeoff
o Landing
o Refueling
o Taxi
44
What is the FIO2 calculation for take off?
(FIO2 x P1) / P2 = FIO2 required for ascent
P1=Sea level
P2=Desired Altitude
45
What should you do if a Diver has the Bens?
o Grab the diving laptop
o Call Divers Alert Network
o The amount of O2 that is running and the time they were placed on it
46
If a 12 lead is presenting with right side Deviation, what should you do?
Move V4 over to the right side of the rib cage
47
An inferior wall MI involves which coronary artery?
Right Coronary Artery
48
A Septal and Anterior wall MI involves which coronary artery?
Left Anterior Descending
49
A Lateral and Posterior MI involves which coronary artery?
Left Circumflex
50
A Posterior wall MI involves which coronary artery?
Posterior Descending Artery
51
Describe Lead I and Lead III during Left Axis Deviation?
Lead I is positive (thumbs up)
| Lead III is negative (thumbs down)
52
Describe Lead I and Lead III during Right Axis Deviation?
Lead I is negative (thumbs down)
| Lead III is positive (thumbs up)
53
How many ml/Hr does a pressure infuser run at 300 mm?
3mL/Hr
54
What is the purpose of a 12 lead?
To find a STEMI
55
Which Lead confirms your Lead placement?
aVR
56
How do you identify Pericarditis in a 12 Lead?
o WIDESPREAD concave ST elevation and PR depression
o Reciprocal ST depression and PR elevation in aVR
o Flat or inverted T waves
57
What is early Repolarization?
Elevation of J-point with a late QRS sluring or notching
58
What is Left Ventricular Hypertrophy?
Deviation of the ST segment in the opposite direction of the QRS complex
Greater than 11mm (positive) indicates L.V.H.
59
What is a Left Bundle Branch Block?
o When the QRS is 120 milliseconds or more
| o Absent Q wave in Leads I, V5, and V6
60
What are the 3 I's of ACS?
o Ischemia
• Demand is greater than the supply of O2
• Elevated T waves (Not Peaked) / Inverted T waves
• ST-Depression
o Injury
• ST Elevation
o Infarct
• Pathological (Wide or Deep) Q waves
61
What locations can a Myocardial Infarct occur?
* Inferior (Special assessment and Treatment)
* Inferolateral
* Posterior
* Anterior
* Anteroseptal
* Lateral
* Right ventricular
62
What is the main cause of Right sided Heart Failure?
Left Sided Heart Failure
63
What is the range for Pulmonary Artery Wedge Pressure, and what is it responsible for?
8-12mmHg
| Measure Right Heart AFTERload and Left Heart PREload
64
What are the symptoms for Pericarditis?
Febrile & Tachycardic
65
After zeroing an Arterial line what do you do next?
Flush it
66
Every pediatric pt that has a central line, how should you check it?
Transduce it
67
What is another name for a Pulmonary Artery Catheter?
A Swanz Ganz Catheter
68
You should not see, what type of pressure during transport?
A Wedge Pressure
69
How long is a pseudo Wedge pressure allowed for?
1 Breath Cycle
| **If its persistent, Deflate the tube or pull the tube back till you see CVP**
70
Critical Care Lyfepak's should be able to monitor how many invasive lines.
2
71
How do you calculate a Coronary Perfusion Pressure?
Diastolic - Pulmonary Wedge Pressure = CPP
72
What is the normal range for Coronary Perfusion Pressure?
50-60 mmHg
73
What is the normal range for Central Venous Pressure, and what is it responsible for?
2 - 6 mmHg
| Measures Right Heart PRELOAD
74
What is the Systolic and Diastolic range for a Right Ventricular Pressure?
Systolic 15-25mmHg
| Diastolic 0-5mmHg
75
What is the normal range for Systolic and Diastolic Pulmonary Artery Pressure?
Systolic 15-25mmHg
| Diastolic 8-15mmHg
76
What is the normal range for Cardiac Output?
4 - 8 L/min
77
What is the normal range for Cardiac Index?
2.5 - 5.0 L/m
78
How do you calculate MAP?
Systolic + 2(Diastolic) / 3
79
How do you calculate Cerebral Perfusion Pressure?
MAP - ICP = CPP
80
How do you calculate a Shock Index?
Heart Rate
----------------------------
Systolic Blood Pressure
81
What is the normal range for Shock Index?
0. 5 - 0.7
| * **Anything greater than 1 the patient is in shock***
82
If you raise your PEEP, what else should you raise?
FIO2
83
How do you calculate Minute Volume (Ve)?
Volume(Vt) x Rate (F) = Ve
84
What is a normal I:E ratio?
1:2
85
What is the maximum for your Peak Inspiratory Pressure?
40
86
Does PIP cause Barotrauma?
No
87
Can a Plateau Pressure cause Barotrauma?
Yes
88
What are the steps for setting up the vent?
```
Strategy
• Protective or Obstructive
Type of Ventilation
• Volume or Pressure
Mode of Ventilation
• A/C, SIMV, PRVC
Settings
• Vt, RR, FIO2, PEEP
```
89
How do you calculate Male IBW?
MALE
| 50 + 2.3 for every inch over 5 feet = IBW (kg)
90
How do you calculate Female IBW?
FEMALE
| 45(kg) + 2.3 for every inch above 5 feet
91
At what Tidal Volume can most adult patients start at?
Vt 400 - 600
92
What is the altitude for the Physiologic zone?
Sea level to 10,000 ft
93
What is the altitude for the Physiologically Deficient zone?
10,000 to 50,000 ft
94
What is the altitude for the Space Equivalent zone?
50,000 to 250,000 ft
95
What is the altitude for Space?
Greater than 250,000 ft
96
How do you calculate the ET Tube?
16 + Age / 4 = ET Tube size
97
Every 33 feet equals how many ATM?
33 feet= 1 ATM (Atmosphere)
98
How many torr is sea level?
760 torr
99
How many torr is Sea level, 10k, 18k, 63k?
Sea level = 760 torr
10,000 ft = 523 torr
18,000 ft = 380 torr
63,000 ft = 0 torr
100
What is Barondontalgia?
It occurs during ascent, it is when air gets trapped in the fillings in your teeth
101
What is Barotitis?
It occurs during descent, it’s when the air gets trapped in the middle ear and blocks the Eustachian tube.
102
What is Barosinusitis?
Occurred during decent and Ascent, it is when air is trapped in your sinuses
103
For every 1000 feet of elevation how much does your temperature change?
2°C
104
When is the emergency action plan activated?
15 minutes after failure to report in
105
How many hours of flight time with a pilot qualify for rotor wing?
2,000 hours
106
How many hours does a pilot need to fly a helicopter to qualify?
1,200 hours in a helicopter
107
How many hours does a pilot have to be in charge at night to qualify?
100 hours as a PIC at night?
108
For FAA rules what is part 91 in part 135?
Part 91-No duty, no weather minimums
Part 125-Max 14 hour duty, 8 hour flight time, 8 hours from last beer
109
What is the size of a hasty landing zone?
100’ x 100’
110
Which direction does a helicopter approach a scene?
Against the wind
111
How many passes are required prior to landing at a hasty landing zone?
Two passes, one high and one low
112
What is the post crash sequence?
Turn off:
Throttle
Fuel
Battery
Assemble at 12 o’ clock position
113
What is the pre-crash sequence?
- Lay the patient flat
- Turn off any oxygen
- Assume the crash position
114
How does the emergency locator transmitter activate?
Itself activates during a crash sequence at 4G’s
115
What are the weather minimums for non-mountainous LOCAL Day/Night?
```
Day = 800’ - 2 miles
Night = 800’ - 3 miles
```
116
What are the weather minimums for non-mountainous CROSS COUNTRY Day/Night?
```
Day = 800’ - 3 miles
Night = 1000’ - 3 miles
```
117
What are the weather minimums for mountainous LOCAL Day/Night?
```
Day = 800’ - 3 miles
Night = 1000’ - 3 miles
```
118
what are the weather minimums for mountainous CROSS COUNTRY Day/Night? 
1000’ - 3 miles
| 1000’ - 5 miles
119
What is the number one and number two causes of crashes?
```
#1 weather
#2 night flight
```
120
What is the glucose level for DKA?
Greater than 350 mg/dL
121
What respiratory pattern is common with DKA?
Kussmaul respirations
122
What is the glucose level for HHNK?
Greater than 600mg/dL
123
 How quickly can you lower glucose for DKA and HHNK patient’s?
No more than 100mg/dL per hour
| MAX 250mg/dL
124
What is Diabetes Insipidis?
A condition where the kidneys are unable to conserve water
125
What is Mallory Weiss/Boerhaave’s Tears?
A rupture of the esophagus
126
What is the treatment for thyroid storm/Grave’s Disease?
IV Fluids first
Beta-blockers
Steroids
Tylenol (fever)
127
What is Cushing syndrome?
“Buffalo hump, Moon face, Thin arms/legs, purple striae abdomen”
It’s a mass on the abdomen
128
What are the signs of Addison’s/Adrenal insufficiency?
Patient presents with depression, malaise, salt craving, And Bronze colored skin
129
What is Gray Turner sign?
Flank ecchymosis caused by hemorrhagic pancreatitis
130
What is Cullen’s sign?
Periumbilical ecchymosis cause by hemorrhagic pancreatitis
131
What are the treatment steps for Hyperkalemia (K+ >5.0) ?
1. Bicarbonate, Insulin, D 50, Albuterol (This pushes K+ back into the cells)
2. Lasix (Gets rid of the excess K+)
3. Calcium Gluconate (Prevents V-Tach)
132
For every 0.6 mEq Potassium change, how much does pH change?
0.1
133
What is Chvosteks Sign?
Cheek muscle spasms when the facial nerve is tapped
134
What is Trousseue’s sign?
Forearm tetany when B/P cuff is applied
135
What is the threshold hypothermia?
35°C = 95°F
136
At what temperature does shivering stop?
32°C = 89.6°F
137
What ekg changes do you find during hypothermia?
Osborn waves / J waves
138
What’s the threshold for Hyperthermia?
40°C = 104°F
